危重症急性胃肠损伤和温下法研究.docVIP

危重症急性胃肠损伤和温下法研究 　　[摘要] 胃肠功能在危重症医学中起着至关重要的作用，胃肠道作为全身炎症反应综合征的触发器和始动器，是脓毒症以及多脏器功能障碍的中心器官，因此胃肠功能受到越来越多的关注和研究。ESICM针对重症患者的胃肠功能衰竭，提出了急性胃肠损伤的概念，应作为今后研究的基础。本文通过对危重症患者胃肠功能衰竭的中医文献研究，发现虚证和虚实夹杂证的证候表现较为突出，脏腑辨证多定位在脾、胃和肠腑，病理因素以寒、气、虚为主。根据笔者多年的临床经验，中药以温下通腹、救逆固脱为大法，助于改善患者的胃肠功能。故寻求中医药治疗方法或者联合中医药治疗手段，并深入研究其作用机制，是危重症患者胃肠功能研究的优势和可能的突破口。 　　[关键词] 急性胃损伤；危重症；温下法 　　[中图分类号] R573.1 [文献标识码] A [文章编号] 1673-7210（2014）08（b）-0087-03 　　Study on acute gastrointestinal injury in critical illness and warm and purgation method 　　FANG Xiaolei WANG Sumei LI Jinxia▲ 　　Emergency Department， Dongfang Hospital Affiliated to Beijing University of Chinese Medicine， Beijing 100078， China 　　[Abstract] Gastrointestinal function plays a crucial role in critical illness. Gastrointestinal tract is the trigger and engine of systemic inflammatory response syndrome， and also is the central organ in sepsis and multiple organs dysfunction. Thus gastrointestinal function receives more and more attention and research. According to gastrointestinal function failure of the concept of acute gastrointestinal injury is given by ESICM， as the basement for further research. This paper has studied the TCM literatures of gastrointestinal function failure of severe patients. And it was found that the performance of deficient syndrome and intermingled deficiency and excess syndrome is more prominent. Zang-fu differentiation often locates in spleen， stomach and intestines. Pathological factors are mainly cold， Qi and deficiency. According to clinical experience for many years， Chinese medicine helps patients improving the gastrointestinal function by using warming purgation fu-unblocking therapy and resuscitation to solidify collapse therapy. So it is the advantage and possible breakthrough in the research of gastrointestinal function for severe patients， if we seek Chinese medicine therapy or western-medicine combining Chinese medicine therapy and study its mechanism deeply. 　　[Key words] Acute gastrointestinal injury； Critical